Permit CITY OF TIGARD MASTER PERMIT
` I COMMUNITY DEVELOPMENT Permit#: MST2023-00211
T I i;A I-Z f3 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/16/2023
Parcel: 2S1060003301
Jurisdiction: Tigard
Site address: 13683 SW 165TH AVE
Subdivision: RIVER TERRACE TOWN CENTER Lot:
Project: River Terrace Town Center, Lot 78
Project Description: New detached dwelling. NO FINAL INSPECTION UNTIL DEFERRED SDC FEES HAVE BEEN
PAID.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 4 First: 112 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 27 Bathrooms: 3 Second: 1173 sf Garage: 502 sf Front: 12 Smoke
Dwelling Units: 1 Third: 1184 sf Right: 3 Detectors: Yes
Total: 2469 sf Value: $402,833.89 Rear: 3
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Bckflw Prevntr: 0
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3
Fum>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add,500 sf: 4 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2469
Owner: Contractor:
AG EHC II(NWHM)MULTI STATE 2 LLC TNHC OREGON LLC Required Items and Reports(Conditions)
BY THE NEW HOME COMPANY INC 15231 LAGUNA CANYON ROAD 1 Ersn Cntrl 503-639-4175
BY KAWANAMI,MARK SUITE 250 2 Geo Tech Required
15231 LAGUNA CANYON RD STE IRVINE,CA 92618 3 1-HR FIRE RATED EAVES
250
PHONE: PHONE: 503-312-6213
FAX:
Total Fees: $24,006.66
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work
will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
the 180 days. ATTEN : Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
oc')-nnl-nnln thrne !CA[? c2.nn1_nnon vro, in a rnrnr of tho re doe nr riirort ni io¢tinnc to nu mu-.by rnllinnn rnz/19 1QR7 nr l Ann'247 721.4
Issued By: t! Permittee Signature: vile Applutiun
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
r
Building Permit Applicati C N D c- 17,2_ in 1-/So
Residentil p 0 p ) Foil(miry Fst:Oil.\
City g MAY! /1 L 3 Received 13 e�) P •—O
of Tigard Date/By: PM ' 1
11111 41 13125 SW Hall Blvd.,Tigard,OR 97 �,OF TIGARD Ptan Review
• _ Phone: 503.718.2439 Fax: 503.59 M- ot�
I DING DIVISION Date/By: 3a Z3 001 '�1
T I G A R n Inspection Inci : 503.639.4175 Date Ready/By: In ' ns SuSeepplemental In Page 4 forformation
Internet: www.tigard-or.gov Notified/Method: u 'IV J 1edi
f
Permit fees*are based on the value of the work performed.
❑New construction ❑Demolition
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
OF � CT� o. work indicated on this application. c01
■ 1-and 2-family dwelling Valuation: $J,g. 1 b c�?J
❑ y g ❑Commercial/industrial it
❑Accessory building El Multi-familyNumber of bedrooms: 4
❑Master builder ❑Other: Number of bathrooms: ;
m m o s �� ON Total number of floors: 3 0 9 7
Job site address:13683 SW 165th ave New dwelling area: 2469 square feet ! I Sq
City/State/ZIP:Sherwood/OR/97140 Garage/carport area: 502 square feet ))"7'�
Suite/bldg./apt.no.: Project name:River Terrace Town Center Covered porch area: square feet ) J. ,
Cross street/directions to job site: Deck area: square feet
SW Jean I o.uise rd Other structure area: square feet
Subdivision:River Terrace Lot no.:78 Permit fees*are based on the value of the work performed.
Tax map/parcel no.:parcel no: 2S 1060003300 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
ECPT� 7 " ri ' r o' ' work indicated on this application.
Valuation: $
Requesting Deferred SDC fees
Existing building area: square feet
New building area: square feet
$;� �O � AN Number of stories:
Name:TNHC OREGON LLC Type of construction:
Address:15231 Laguna Canyon RD STE 250 Occupancy groups:
City/State/ZIP:Irvine/CA/92618 Existing:
Phone:(503)310-7571 Fax ( )
New:
Business name:TNHC OREGON LLC " LOMea
k
Structural plan review fee(or deposit):
Contact name:Frank Sandoval
FLS plan review fee(if applicable):
Address:15455 NW Greenbrier Parkway Suite 240
City/State/ZIP:Beaverton/OR/97006
Total fees due upon application:
Amount received:
Phone:(503) 310-7571 Fax: :( ) q j it
E-mail: fsandoval@nwhm.com
w Commercial and residential prescriptive installation of
ateitanintrintatitat . 1 '.R ACT OR ...`.. .. i ;u. ., w f` ., i, roof-top mounted Photo Voltaic Solar Panel System.
Business name:TNHC OREGON LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:15231 Laguna Canyon RD STE 250 Solar Installation Specialty Code checklist.
City/State/ZIP:Irvine/CA/92618 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503 )310-7571 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:241108
Total fee due upon application: $201.60
Authorized signature: 171 This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Frank Sandoval Date:5/8/2023 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 01/25/2023 440-4613T(1 1/02/COM/WEB)
Mechanical Permit Application ILL,l il ' 6..
FOR OFFICE USE oNI.1
City of Tigard Received my� /�
. , g ,r t! 8 "'1n?: Date/By: Per!"' / 3 ,-V0 Dl 13125 SW Hall Blvd.,Tigard,OR 97223 G+:u Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
II G A R D Inspection Line: 503.639.4175 C r(C o��,F 1
e Date Ready/By: luris: la See Pa e 2 for
Internet: www.tigard-or.gov
Bg
L1 { ;f4tified/Method: Supplemental Information
Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:S
® 1-and 2-family dwelling ❑Commercial/industrial
❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder 0 Other: Description p Qty. Ea. Total
r;" Heating/cooling:
Air conditioning 1 46.75
Job site address:13683 SW 165th ave Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Sherwood OR 97140 Furnace 100,000+BTU(ducts/vents) 1 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:River Terrace Town Center
Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
SW Jean Louise rd Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision:River Terrace Town Center Lot no.:78 other 23.32
Other fuel appliances:
Tax map/parcel no.:2s1060003300 Water heater 23.32
WI8.: < ; t �v Gas fireplace/insert 1 33.39
Flue vent for water heater or gas
NEW HOME CONSTRUCTION fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
� .,:
�' 'f" ' " """"'� ' ' `'"`" "`""`t"'° M M °x: Environmental exhaust and ventilation:
Name:TNHC OREGON LLC Range hood/other kitchen
equipment 1 33.39
Address:15231 Laguna Canyon Rd STE 250 Clothes dryer exhaust 33.39
City/State/ZIP:Irvine CA 92618 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)310 7571 Fax:( )
Attic/crawlspace fans 23.32
r,
5,,.::..:. ,. 11 ,.:,u ; ......i:;,., _ .`., 07 1 4m t, , SIw..:: Other: 23.32
Business name:TNHC OREGON LLC Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Frank Sandoval Furnace,etc.
Address:15455 NW Greenbrier Parkway#240 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Beaverton OR 97006 Water heater
Phone:(503)310-7571 Fax::( ) Fireplace
Range
E-mail:fandoval@nwhm corn Barbecue
�... t o
x d' Clothes drY er(gas)
Business name:Pro Heating and Cooling, INC Other
Address:4200 NW Leisy rd
Subtotal
n .f. ....x, 1,:1 ..° ..:.I..< .w...:::: total ...u..: .... ,:
City/State/ZIP:Hillsboro, OR 97124 Minimum permit fee($90.00)
(971 n05 4989 ( ) Plan review(25%of permit fee)
Phone: Fax:
State surcharge(12%of permit fee)
CCB lie.:209001 TOTAL PERMIT FEE
/� This permit application expires if a permit is not obtained within 180
f/ G�'L days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date:3/17/2023
i\Building\Permits\MFC_PermitApp_040113.doc 440-4617T(1 l/02/COM/WEB)
Electrical Permit Application RECEIVE I FOR OFFICE I SE 0\'1.v
City of Tigard Received Date/By: Permit#: tV� V ,Ooti1 l
13125 SW Hall Blvd.,Tigard,OR 97223 OCT T
g Phone: 503.718.2439 Fax: 503.598.1960 2023 Dn Review
Da
teBy: Related Permit#:
i I t,1 Ft I) Internet:
Line: 503.639.4175 ReadyDateB
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: luris Supplemental See Pent 2 Inr
BUILDING DIVISIO °f°rmati°°
TYPE OF WORK PLAN REVIEW
®New construction 0 Addition/alteration/replacement Please check all that apply(submit2 sets of plans w/items checked):
0 Service or feeder 400 amps or more El over three stories.
0 Demolition 0 Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or P 0 Floating buildings.
ICI 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building El Commercial-useagricultural
less to ground,or exceeds 14,000
❑Multi-familyamps for all other installations. buildings.
0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION`AND LOCATION 0 Emergency system. larger separately derived
Job#: I Job site address: 3683 SW 65th ave 0 Addition of new motor load of system.
100HP or more. ❑"A""E" `I.2" "I-3>
❑Six or more residential units. occupancy.
City/State/ZIP: Sherwood/ O R/ 97140
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: I Project name: RTTC ❑Hazardous locations. 0 Supply voltage for more than
Cross street/directions to job Site: ❑Service or feeder 600 amps or more. 600 volts nominal.
FEE SCHEDULE
SW River Terrace blvd Description 1 Qty. 1 Each 1 Total 1
New residential single-or multi-family dwelling unit.
Subdivision: River Terrace Town Center I Lot#:78 Includes attached garage.
Tax map/parcel#: 2s1060003300 1,000 sq.R.or less 168.54 4
Ea add'1500 sq.ft.or portion 33.92 i
DESCRIPTION OF WORK Limited energy,residential
NEW HOME CONSTRUCTION (with above sq.ft.) 75.00 2
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
54
PROPERTY OWNER TENANT Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
Name: THNC OREGON LLC 200 amps or less 100.70 2
Address: 15231 Laguna Canyon Rd STE 250 201 amps to400amps 133.56 2
City/State/ZIP: Irvine CA 92618 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Phone:(503)310-7571 I Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: Fsandoval@newhomeco.com
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
14 APPLICANT 1 ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
Business name: THNC OREGON LLC A.Fee for branch circuits with
above
each servibranchceci orrcu feederit fee,
Contact name: Frank Sandoval
7.42 2
B.Fee for branch circuits without
Address: 15455 NW Greenbrier Parkway#240 service or feeder fee,first 56.18
branch circuit 2
City/State/ZIP: Beaverton OR 97006 Each add'l branch circuit 7.42 2
Phone:(503)310-7571 Miscellaneous(service or feeder not included)
I Fax::( ) Each manufactured or modular
Email: dwelling,service and/or feeder 67.84 2
Fsandoval@newhomeco.com
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Development Northwest Inc., DBA Wolcott Electrical Sign or outline lighting 67.84 2
Address:1075 W Historic Columbia River Hwy Signal circuit(s)or limited-energy
panel,alteration,or extension. 0 See Page 2 2
City/State/ZIP:Troutdale, OR, 97060 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr Phone:(503)853-9420 I Fax:( ) Investigation(1 hr min) 90.00/hr
Email:MWOLCOTT@WOLCOTT.PRO Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is
CCB Lie.:112220 I Electrical Lie.:C 1272 l Suprv.Lie.:5782S specifically listed(/3 hr min) 90.00!hr
Suprv.Electrician signature,required ELECTRICAL PERMIT FEES
orva c.mae<i ..:z,ran A.e not Subtotal:
Print name:David Campbell I Date:10/12/2023 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: w 4 xA TOTAL PERMIT FEE:
I Print name:Malachi J. Wolcott This permit application expires if a permit is not obtained within 180
Date:10/12/2023 I days after it has been accepted as complete.
* Number of inspections allowed per permit.
1:1BuildingTermitslELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-46I5T(1 1/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Description I Qty. I Each L Total I •
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
n Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva-no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed('/z hr min)
COMMERCIAL WORK ONLY: ELECTRICAL.PERMIT.FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
(SEE OAR 918-309-0000) * Number of inspections allowed per permit.
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
El Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
l\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015
s
'w
Plumbing Permit Application , ,e.t, „' r,
Building Fixtures ,,
City of Tigard {6 °i 273,,7�'°� Dare/By:Received per244, C7 -00;4 u
; . 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
r ,-.,r"7^ '' ,7)Date/By: Other Permit No.:
T I G A R D Inspection Line: 503 639.4175 9 to Ready/By: Juris See Pa e 2 for
Internet www tigard or gov r .r q >
�
tt ie Met od Supplemental Information
®New construction ❑Demolition For special information use checklist
Description I Qty. 1 Ea. I Total
❑Addition/alteration/replacement ❑Other New 1-2-fa mity dwellings(includes 100 ft for each utility connection)i fr SFR(1)bath 312.70
®1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 1 437.78
❑Accessory building ❑Multi-family SFR(3)bath 500.32
❑Master builderEach additional bath/kitchen 25.02
❑Other: Fire sprinkler( sq.ft.) Page 2
i; El #1 d t it t' 03
-, ....." .. ....,�j .,,,...:. ....Wf.:: r Site utilities:
Job site address:13683 SW 165th ave Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Sherwood OR 97140
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name:River Terrace Town Center Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
SW Jean Louise rd Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision:River Terrace Town Center I Lot no.:78 Fixture or item:
Tax map/parcel no.:2s1060003300 Backflow preventer 31.27
Backwater valve
1 ,61 all 12.51
NEW HOME CONSTRUCTION osommllent
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
` t ..r ;' ud x Expansion tank 12.51
Name:TNHC OREGON LLC Fixture/sewer cap 25.02
Address:15231 Laguna Canyon Rd STE 250 Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP:Irvine CA 92618 Hose bib 25.02
Phone:(503 $10-7571 Fax:( ) Ice maker
1:11.6 ��1 , f `-' Interceptor/grease s� . .:..,�. � � `�: trap 25.02
Business name:TNHC OREGON LLC 1 Medical gas(value:$ ) Page 2
Contact name:Frank Sandoval
Primer 12.51
Roof drain(commercial) 12.51
Address:15455 NW Greenbrier Parkway#240 Sink/basin/lavatory 25.02
City/State/ZIP:Beaverton OR 97006 Solar units(potable water) 62.54
Phone:(503 310-7571 Fax: :( ) Tub/shower/shower pan 12.51
E-mail:fsandoval@nwhm.com Urinal 25.02
g zt Water closet
, : 25 02
. .: ...... .:,�.�,,.x ,..,. i ...W: .. .:;r.. .,t, . ` ... Water heater 37.52
Business name:G&B Plumbing & Sons, INC
Water piping/DWV 56.29
Address:PO BOX 92 Other 25.02
City/State/ZIP:St. Paul, OR 97137 Subtotal
Phone:(503 868 1417 Fax:( ) Minimum permit fee: $72.50
CCB Lic.:184372 Plumbing Lic.no.:4613.���� Plan review (25%ofpermit fee)
�� State surcharge(12%of permit fee)
Authorized signature: �/ Q
�6� J TOTAL PERMIT FEE
Print name:Kelly Fowler Date:3/17/2023 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
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f- 0 ` ) ' t Building Division
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_, .ate : 4: ., . - - ' One & Two-Family Dwelling
T1 GA1. i . "F c i iC et. Fees Checklist
}R PORT sr flEQt R D
« ,.:,t ''.9 e i s r:. FOO n kiG { II
PERM ~ 3 i teTtI 1I `1 'i i"i Application Date -FEE VERSION Wi Z t' '
, ' at na ,moo
Permit#: Plan #:
1��Z}5 �(7�l UP`j p f U Floors:
Valuation: �02.1 (a.33, � Covered Porch: l Basement l I D -
Bedrooms: LI Deck: 1st Floor (1 7 3
WC (toilets) 3 Deck Cover: - 2nd Floor it q#4
Lavatories 6j Patio Cover - - 3rd Floor
r
Tub/shower 3 Accessory Struct. �— R-3 Total P2>( (Q'j
Laundry Tray Water Heater t. / Gas /(Ele) Garage Sb Z
Exhaust Vents G lue Vents - Total for Elec. 21 —1
Backflow Prey. _� Furna / Heat Pump AC # for Electrical I
BBQ Gas Fireplace ya� #Fuel Lines 3
FEES: Description: Fee Applie Fee Entered
DC Prov Revw: Planning
Info Proc/Arch: Lg$2,00 (over 11 x17) 0 C
Info Proc/Arch: Sm$.50 (up to 11x17) 746
Metro CET: Residential Use
0
School CET: District: w� -9\
Tigard CET: Admin
Tigard CET: ODHCS `�
Tigard CET: AH `�
Electrical Permit: Permit Fee:
Limited Energy: L
12% State Surcharge
Mech. Permit: Permit Fee:
12% State Surcharge
Plumbing Permit: Permit Fee: tZ
12% State Surcharge 1.
Erosion Control: w/Permit- Ping
Notes:
I:\Building\Forms\ResPlanCheckFees_Dec2022_AA.doc 12/21/22
Page 1
City of Tigard
li "' COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARD
,,,Building Permit #: 14nr t-ram a-037) -O0 ?4
Site Address: 13683 SW 165th Ave 7 Verified in Accela
Project Name: River Terrace Town Center Lot/unit #: 78
Proposal: New Single Detached SFR Zone: RES-C
Housing Type: V SFR(R'Single Detached ❑ Duplex❑Triplex❑ADU) ❑ Rowhouse❑Cottage Cluster❑ CYU ❑Quad ❑Other
Required Site Plan Elements:
t '3 copies of site plan on max 11x17"
(Drawn to standard scale 0 Retained bees, di ip line/ bee pi ulcdion
lif North arrow fZ(Street and site trees shown / labeled
V Site address, project name, lot # ❑ Table calculating trcc canopy at maturity
'Street names (N/A for SFR)
'Applicant name and phone # yard rectangle dimcnsioncd (if applicable)
M'Lot and setback dimensions V Vision clearance triangle
❑ Existing sli uetoi cs&syuai a fuetage V Utility locations &easements
V Footprint of new structure and FFE V Property corner elevations
V Sidewalk/driveway dimensioned VLIDA (>1,000 sf disturbance)
'Lot area and lot coverage percentage ®'Erosion control
Required Elevation Plan Elements:
(For SFR: calcs needed only on street-facing) Summary table with calculations for:
VDrawn to standard scale VTotal façade area
171 Building height dimensioned VTotal window and door area
'Facade dimensioned
V Windows and doors dimensioned
'V Garage doors dimensioned
Requi an Elements:
(Not required for SFR ❑ Summary table that includes
❑ Each story dimensioned otal floor area
0 Each story floor area calculated ❑ Floor ar
Planning Review
The following,standards have been met:
Setbacks LI Front:12 porch
s Rear: 3'alley Side: 3' Min/Max Street Side: 7' / NA Garage: 3' alley
Height E Max. Height: 35' Proposed Height: 26'-5"
'1 Yes ❑ N/A Landscape
❑ Yes ji N/A Screening (Quad only)
V Yes ❑ N/A % Window Coverage
VYes ❑ N/A Garage (SFR Only) Parking (Other Res)
S'Yes ❑ N/A Entrance (SFR, Rowhouse, Quad only)
❑ Yes N/A Other building design standards (Rowhouse only)
❑ Yes N/A Accessory Structure Standards
❑ Yes No Qualifying pre-existing unit exempt from standards (Cottage unit only)
Additional standards for Courtyard Units, Cottage Clusters, Rowhouses, and Quads:
❑ Yes N/A Unit Count:
❑ Yes N/A Lot Width and Size
❑ Yes N/A Pathway
Additional standards for Courtyard Units and Cottage Clusters only:
❑ Yes N/A Unit Area:
❑ Yes N/A Floor Area (per story)
❑ Yes N/A Courtyard
O Yes N/A Fence
,
❑ Yes ❑ No 'N/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995)
❑ Yes ❑ No ON/A Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes 0 No
Applied For: ❑ Yes ❑ No, stop intake
❑ Sensitive Lands: 'I Yes ❑ No
6'Main Land Use Case #s: PDR2021-00004 ❑ Conditions met
❑Applicant notified of land use expiratio e: Submit and pay for all pplicabl v permits by 1/31/2025.Final occ by 1/31/2027
Approved By Planning: ...,., irk �- Date: 3/14/2023 5/2/ '
Notes Permit can be issued prior to fin I at approval but not for to c nditions being met on PDR
Revision 1: ❑ Approved ❑ Not Approved Date:
Revision 2: 0 Approved El Not Approved Date:
Building Permit Submittal /
@ Original Smittal Date: s/e/�T
Site Plans #ub: "S'
Building Plans #: 3
Building Permit #: ErBuilding permit # entered on page 1
Y Workflow Routing: r Planning X Engineering y Permit Coordinator A Building
Workflow Sign-off: Sign-off for Planning (include notes from planning review)
Route Documents: fg Engineering: (1) copy of permit application, (1) site plan, (1) building plan
I and original plan review routing form.
A Building: original permit application, site plans, building plans, engineer and
beam calculations and trust details, if applicable, etc. //�7 i
Permit Technician: L.. Date: 5 / J
Notes:
4 Engineering Review
❑ PFI Permit:
8' Slope at building pad: ,ZpA
oh
k OfConditions met prior to issuance of permit
❑ Easements (encroachments) per engineering conditions of approval and plat
0 Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes 0 No
Assess Water Quantity Fee in-lieu: ❑ Yes 0 No
LIDA Facility on lot: 0 Yes ❑ No Add Fee: CIYes CINo
l Final Plat Recorded
0 NOT Approved: Date:
Notes:
Approved By Engineering: Date: 5/22/��
•NINRevision 1: ❑ Approved ❑ Not Approved Date:
Revision 2: 0 Approved ❑ Not Approved Date:
S
A Permit Coordinator Review
1
1 t onditions met prior to permit issuance
,Approved, NOT Released: AL Date notified applicant: 011 12023
❑ ENG Revisions Required: Date notified applicant:
iC SDC Exemption: ❑ Applied for El Received 7Does not apply
... 156C Fees Entered: Wash Co Trans Dev Tax: pYes 0 N/A
Tigard Trans SDC: 7Yes ❑ N/A Deferred
Parks SDC: p.Yes 0 N/A L Deferred
LIDA 0 Yes l/A
Q
K to Issue/Approved by Permit Coordinator: ` Date: tb' LD Z3
Revision 1: ❑ Approved ❑ Not Approved Date:
Revision 2: ❑ Approved 0 Not Approved Date:
a-x
x, a `,
cd L, J
City of Tigard O ' ' . )
Defeal Until Occupancy Request '' °'``'' ' ,w `' ;;�
rr
■ p Y
T[G A R D Washington County Transportation Development Tax(TDT),Transportation and Parks System
Development Charges (SDCs)
This form is to be signed and submitted prior building permit issuance or,if no building permit is required,then
upon land use approval(TMC 3.24, as amended by Ordinance No.21-09).
Date: 5/23/2023 Site Address: 13683 SW 165th
Project River Terrace Town Center Land Use Case or
Name: Building Permit#: MST2023-00211
Tax Lot Lot 78 Total Parks $11,830.00
#: Amount*:
TDT Total TSDC
Amount: N/A Amount*: $12,004.00
*The total TSDC amount shown above is the sum of$ 7,760.00 for TSDC-Improvement,$ 448.00 for TSDC-
Reimbursement,and$ 3,769.00 for TSDC-River Terrace,if applicable..
*The total Parks SDC amount shown above is the sum of$ 6,812.00 for Parks-Improvement,$ 1,887.00 for Parks-
Reimbursement,and either S N/A for Parks-Neighborhood or$ 3,131.00 for Parks-Neighborhood River Terrace.
This constitutes my request to defer payment of the TDT,TSDC, and Parks SDCs, as provided above,
until occupancy.
Payment of the TDT,TSDC,and Parks SDCs may be deferred until issuance of the occupancy permit. In
requesting this option, I understand that any deferred TDT,TSDC, and Parks SDCs must be paid prior to final
inspection or issuance of an occupancy permit.
TDT may only be deferred if the TOT is greater than the amount for a single-family residence. I further
understand that the amount of TDT due on deferred obligations shall be the amount in effect at the time of
issuance of the building permit.
For a deferral request to be accepted both the Property Owner and the Developer must sign this request.
Property Owner ._,_ Date: -5 . Q .��
Developer: Date: Sao,,e3,
cif-.. ------)(
Permit Coordinator: Date: 5/23/2023